Restoring melancholia in the classification of mood disorders

Received 8 January 2007; received in revised form 21 May 2007; accepted 29 May 2007.

Abstract

The present DSM criteria for major depression poorly identify samples for treatment selection, prognosis, and assessments of pathophysiology. Melancholia, in contrast, is a disorder with definable clinical signs that can be verified by laboratory tests and treatment response. It identifies more specific populations than the present system and deserves individual identification in psychiatric classification. Its re-introduction will refine diagnosis, prognosis, treatment selection, and studies of pathophysiology of a large segment of the psychiatrically ill.

Keywords: Melancholia, Diagnosis, Classification, Major depression, Bipolar disorder

a Professor of Psychiatry Emeritus, Rosalind Franklin University of Medicine and Science, North Chicago Illinois, United States

b Adjunct Clinical Professor of Psychiatry, University of Michigan, Ann Arbor, United States

c Professor of Psychiatry and Neurology Emeritus, State University of New York at Stony Brook, United States

Corresponding author. P.O. Box 457, St. James, New York 11780-0457. Tel.: +1 631 862 6651.

1 1407 Lincoln Avenue, Ann Arbor MI 48104. Tel.: +734 998 1383

PII: S0165-0327(07)00215-7

doi:10.1016/j.jad.2007.05.023

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